Saikia Kabul C, Bhattacharyya Tulsi D, Bhuyan Sanjeev K, Bordoloi Bikas, Durgia Bharat, Ahmed Firoz
Department of Orthopaedics, Gauhati Medical College, Guwahati, Assam, India.
Indian J Orthop. 2011 Mar;45(2):168-73. doi: 10.4103/0019-5413.77138.
Giant cell tumor of bone (GCT) is a benign lesion with great propensity for local recurrence. This study aimed to analyse the rates of local recurrence and its possible predisposing factors in Campanacci's Grade III and II GCT of long bones following intralesional curettage and bone cementing.
32 cases of either sex with Campanacci's Grade II (n= 14), and Grade III (n=18) with intact articular surface, operated between 1995 and 2007 in form of intralesional curettage and bone cementing were studied. All the cases were followed up for 2.5-12 years (mean, 6.5), after primary treatment. The mean age at operation was 32.4 years (range, 18.5-40 years). The proximal tibia was involved in 13 cases (40.6%), followed by distal femur (n=11)34.4% distal tibia (n=3) 9.4%, proximal femur (n=2) 3.2% and distal radius (n=3) 9.4%.
Eleven patients (34.4%) had local recurrence, of which eight were of Campanacci's Grade III. The mean recurrence time was 14 months (range, 3-34 months). The two-year recurrence-free survivorship was 71.9% (n=23/32). Post-recurrence mean follow-up was 4.2 years (range, 2-6.5 years).
We observed higher rate of local recurrence with Campanacci's Grade III GCTs. We recommend selective use of this procedure in Grade III lesions, particularly with extensive soft tissue involvement.
骨巨细胞瘤(GCT)是一种具有高度局部复发倾向的良性病变。本研究旨在分析长骨Campanacci II级和III级GCT经病灶内刮除和骨水泥填充术后的局部复发率及其可能的诱发因素。
研究1995年至2007年间接受病灶内刮除和骨水泥填充手术的32例Campanacci II级(n = 14)和III级(n = 18)、关节面完整的患者,男女不限。所有患者在初次治疗后随访2.5 - 12年(平均6.5年)。手术时的平均年龄为32.4岁(范围18.5 - 40岁)。胫骨近端受累13例(40.6%),其次是股骨远端(n = 11,34.4%)、胫骨远端(n = 3,9.4%)、股骨近端(n = 2,3.2%)和桡骨远端(n = 3,9.4%)。
11例患者(34.4%)出现局部复发,其中8例为Campanacci III级。平均复发时间为14个月(范围3 - 34个月)。两年无复发生存率为71.9%(n = 23/32)。复发后的平均随访时间为4.2年(范围2 - 6.5年)。
我们观察到Campanacci III级GCT的局部复发率较高。我们建议在III级病变中选择性使用该手术方法,尤其是软组织广泛受累的情况。